MOESM3 of Severe metabolic acidosis after out-of-hospital cardiac arrest: risk factors and association with outcome

Additional file 3: Table S2. Specificity and sensibility of base deficit, arterial blood lactate bicarbonate and pH level

MOESM2 of Severe metabolic acidosis after out-of-hospital cardiac arrest: risk factors and association with outcome

Additional file 2: Table S1. Characteristics of patients in the fourth base deficit quartile (base deficit > 13) according to vital status at ICU discharge

MOESM1 of Severe metabolic acidosis after out-of-hospital cardiac arrest: risk factors and association with outcome

Additional file 1: Fig. S1. Base deficit distribution in the Study population. Red dashed lines represented 25%range interquartile, median and 75% range interquartile, respectively

Comparison of four clinical risk scores in comatose patients after out-of-hospital cardiac arrest

Background and aims: Several different scoring systems for early risk stratification after out-of-hospital cardiac arrest have been developed, but few have been validated in large datasets. The aim of the present study was to compare the well-validated Out-of-hospital Cardiac Arrest (OHCA) and Cardiac Arrest Hospital Prognosis (CAHP)-scores to the less complex MIRACLE2- and Target Temperature Management (TTM)-scores. Methods: This was a post-hoc analysis of the Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial. Missing data were handled by multiple imputation. The primary outcome was discriminatory performance assessed as the area under the receiver operating characteristics-curve (AUROC), with the outcome of interest being poor functional outcome or death (modified Rankin Scale 4–6) at 6 months after OHCA. Results: Data on functional outcome at 6 months were available for 1829 cases, which constituted the study population. The pooled AUROC for the MIRACLE2-score was 0.810 (95% CI 0.790–0.828), 0.835 (95% CI 0.816–0.852) for the TTM-score, 0.820 (95% CI 0.800–0.839) for the CAHP-score and 0.770 (95% CI 0.748–0.791) for the OHCA-score. At the cut-offs needed to achieve specificities >95%, sensitivities were <40% for all four scoring systems. Conclusions: The TTM-, MIRACLE2- and CAHP-scores are all capable of providing objective risk estimates accurate enough to be used as part of a holistic patient assessment after OHCA of a suspected cardiac origin. Due to its simplicity, the MIRACLE2-score could be a practical solution for both clinical application and risk stratification within trials

28-day mortality probability according to the BRASS.

<p>Mortality probability expressed in mean [95%CI], BRASS: Brainstem Responses Assessment Sedation Score.</p

Flow chart.

<p>NMBA: neuromuscular-blocking agent; RASS: Richmond Assessment Sedation Scale.</p

Latent class description and outcomes.

<p>Latent class description and outcomes.</p

Patient characteristics.

<p>Patient characteristics.</p

Representation of homogeneous and heterogeneous profiles.

<p>The percentage of abolition of each tested neurological responses in homogeneous and heterogeneous profiles are depicted. The heterogeneous profile is characterized by a greater and more heterogeneous abolition of neurological responses.</p

Association between heterogeneous sub-phenotype and 28-day mortality.

<p>Association between heterogeneous sub-phenotype and 28-day mortality.</p